本決策輔助工具之題目為 “青少年第一次大範圍自發性氣胸發病是否需接受胸腔鏡手術?”，適用對象為當醫師診斷了青少年病人患有「原發性自發性氣胸」 (簡稱自發性氣胸)，且病患不確定要接受保守治療或手術治療時與病人討論使用。自發性氣胸為兒童青少年常見疾病，第一次發生往往在15到18歲的高中時期，主要症狀為胸痛及呼吸喘。當醫師懷疑病人有自發性氣胸時，會安排胸部X光片檢查確定診斷。所謂大範圍氣胸一般是指縮小的肺部的肺尖到胸壁距離大於3 cm或是肺門高度的肺部到胸壁距離大於2 cm。
小範圍自發性氣胸第一次發病一般醫師會建議臥床休息及氧氣治療，但第一次大範圍自發性氣胸的青少年病人確診之後，常無法完全自主判斷治療策略，醫護人員應提供充份資訉讓病人及其父母瞭解並共同做岀合適的選擇。
本輔助工具自2018年開始使用，於2020年依據臨床的使用狀況加以更新，更新圖片及使目標族群更明確，並邀請臨床醫護人員測試。

1. Janahi, IA. Spontaneous pneumothorax in children. In: UpToDate, Post, TW (Ed), UpToDate, Waltham, MA, 2020.
2. Brown SGA, Ball EL, Perrin K, et al. Conservative versus Interventional Treatment for Spontaneous Pneumothorax. N Engl J Med. 2020;382(5):405-415. doi:10.1056/NEJMoa1910775
3. Furia S, Breda C. Primary spontaneous pneumothorax in children and adolescents: a systematic review. Pediatric Medicine. 2019; vol 2.
4. Vuong NL, Elshafay A, Thao LP, et al. Efficacy of treatments in primary spontaneous pneumothorax: A systematic review and network meta-analysis of randomized clinical trials. Respir Med. 2018;137:152-166. doi:10.1016/j.rmed.2018.03.009
5. Williams K, Baumann L, Grabowski J, Lautz TB. Current Practice in the Management of Spontaneous Pneumothorax in Children. J Laparoendosc Adv Surg Tech A. 2019;29(4):551-556. doi:10.1089/lap.2018.0629
6. Bobbio A, Dechartres A, Bouam S, et alEpidemiology of spontaneous pneumothorax: gender-related differencesThorax 2015;70:653-658.
7. Inverso G, Dodson TB, Gonzalez ML, Chuang SK. Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction. J Oral Maxillofac Surg. 2016;74(3):474-479. doi:10.1016/j.joms.2015.10.009
8. Seguier-Lipszyc E, Elizur A, Klin B, Vaiman M, Lotan G. Management of primary spontaneous pneumothorax in children. Clin Pediatr (Phila). 2011;50(9):797-802. doi:10.1177/0009922811404699
9. Robinson PD, Cooper P, Ranganathan SC. Evidence-based management of paediatric primary spontaneous pneumothorax. Paediatr Respir Rev. 2009;10(3):110-117. doi:10.1016/j.prrv.2008.12.003
10. Baumann MH, Strange C, Heffner JE, et al. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest. 2001;119(2):590-602. doi:10.1378/chest.119.2.590.